First he took on the gun lobby — and won. Then Big
Tobacco. Now Vinny DeMarco has turned his power of mass
persuasion to getting health care coverage for Maryland's
uninsured.
By Catherine
Pierre

Opening Photo: Vinny DeMarco and Molly Mitchell,
with their sons, Jamie (left) and Tony, and Paz, the family
dog.Photo by John
Davis

When Vinny DeMarco arrived in Annapolis that April morning,
he thought he had a winner. It was the last day of the 2004
Maryland General Assembly session, and the bill his
organization, Maryland Citizens' Health Initiative (MCHI),
had been working to get passed was up for a vote. If House
Bill 1271 passed, about 76,000 Marylanders without health
insurance would get it, and many thousands more would have
access to free preventive care. The bill would eliminate
the HMO exemption to the 2 percent tax on premiums that all
other Maryland health insurance companies pay, and the
funds generated would be used to expand Medicaid.

DeMarco's optimism is legendary — the Baltimore
Sun once wrote that he "could find the bright side of
an Internal Revenue Service audit" — but his sunny
outlook on this day was well founded. The bill had been
passed in the House two weeks earlier, the Senate version
had changes DeMarco was pleased with, and he was confident
of a majority support.

DeMarco, MCHI's president, and the rest of the staff had
been laying the groundwork for this vote for almost five
years. They had originally put together a proposal called
Health Care for All! The bill was a complex and ambitious
plan to guarantee quality and affordable health care in
Maryland that never made it past the Senate Finance or
House Health and Government Operations Committee hearings
in February. When that bill died, the Baltimore-based MCHI
threw its support behind HB1271, a bill sponsored by
Delegate John Hurson, chairman of the HGOC.

On the day of the vote, DeMarco arrived early. He spent the
day patrolling the halls outside the Senate chamber,
catching senators when he could, answering questions when
asked, but mostly waiting. When a Senate committee staffer
called DeMarco two hours before the end of the session, he
was floored. Despite his efforts, the bill had failed 24 to
22.

"I was in shock for a while," says DeMarco. "I was in a
daze. It's 10:30 at night, I've been there since 7 in the
morning. I'm completely exhausted. It's raining out. And I
just saw this work, all these people's hard work gone down
the tubes — temporarily. And I just kept thinking
that 70,000 people who don't have health care would have
gotten it, and now aren't."

It's hard to say exactly what happened. Maybe it was too
much to expect the Senate to pass a tax increase in a year
of budget deficits. Some people have speculated that the
bill was the victim of political infighting. And Governor
Robert Ehrlich — who is, legislatively speaking, one
of the most powerful governors in the country —
opposed the bill.

"Our goal this session was to pass the very big step that
this was, and then keep working on our plan," says DeMarco.
"The fact that it came so close was a combination of
extremely frustrating and good news for the future."

Parris Glendening with DeMarco and family after signing
the tobacco tax increase into law. "The future is looking
brighter!" Glendening wrote.

Vinny DeMarco, A&S '79, '81 (MA), is used to tough fights.
First it was gun control. In the late 1980s, he led a
successful effort to ban Saturday Night Specials in
Maryland, then fought off the National Rifle Association's
$7 million effort to overturn the ban through a referendum.
He successfully lobbied for several subsequent gun-control
measures, including the 1996 Maryland Gun Violence
Prevention Law, which limits the number of guns an
individual can purchase in the state to one per month.

In the '90s, it was tobacco. Studies show that higher
prices discourage teenagers from smoking, so DeMarco worked
closely with then-Governor Parris Glendening to increase
the state's tobacco tax. "According to the data, a couple
years later, 20,000 fewer kids smoked," says DeMarco.

DeMarco's causes, and his tireless efforts in support of
them, have made him a fixture in Maryland politics. Around
Annapolis, he has built a reputation — as an eternal
optimist, a relentless nudge, an affable guy who bears a
jar of his Italian mother's tomato sauce when greeting
politicians, a man whose heart is in the right place.

"He has a chance to do good and save lives," says Eric
Gally, MCHI's lobbyist. "And he likes doing it."

Jen Hobbins, a member of MCHI's board, recalls her
conversation with a fellow member in an elevator on the way
to a meeting with DeMarco: "He turned to me and said, 'Now,
which good thing does Vinny have us here for today?'"

His latest cause is health care. And DeMarco, who friends
have likened to the detective Columbo — a little
rumpled and disorganized, but razor sharp when it comes to
getting the job done — is bringing his well-tested
method of campaigning to the effort.

"He is a master of grassroots organization in Maryland,"
says Delegate Maggie McIntosh, who has known DeMarco since
he was a student at Hopkins. "He has an idea, and the next
thing you know, six months later, he has an office, a
budget, and a thousand organizations signed on to help
him."

Not everyone supports DeMarco's causes — or his
methods. But most recognize that he is effective.

"I have never met anybody in this process who had more
focus and energy on a single issue that Vinny does," says
Dennis McCoy, a government affairs attorney who counts the
tobacco company Philip Morris among his clients. "Sometimes
that focus and energy carry the day."

DeMarco offers Vice President Al Gore a jar of his
mother's tomato sauce.

There are 44 million people without health care coverage in
the United States. In Maryland alone, close to 700,000
people have no health insurance whatsoever, and hundreds of
thousands of underinsured can't afford primary preventive
care. For them, sickness can mean missed work, crippling
hospital bills, sometimes even bankruptcy. By law, a
critically ill person can't be turned away from an
emergency room, so those who have health insurance
subsidize those who don't.

This does not sit well with Baltimore City Health
Commissioner Peter Beilenson, SPH '90 (MPH).

"I frankly cannot believe that we continue to allow
ourselves to be one of three major countries left in the
world — Turkey and Mexico being the others —
that do not have universal health coverage," Beilenson
says. "Yet we're the wealthiest, most technologically
advanced country in the world. It is simply
unconscionable."

In 1998, frustrated by the fact that even during an
economic boom there were more Marylanders without health
insurance than there had been a decade before, Beilenson
wanted to do something about it. "It was very clear to me
that so much of what we're doing in public health is
filling in gaps or doing the band-aid approach to health
care," he says. Anytime the city looks for funding —
for drug treatment or cancer screening programs, for
instance — it's to help the uninsured. "Why not go
for the comprehensive approach?" he asks.

When Beilenson began to get a group together to work on a
plan and needed someone to head things up, he thought of
DeMarco, whose tobacco tax campaign was nearly complete. "I
knew he was about to be successful again and work himself
out of a job," says Beilenson.

As health commissioner, Beilenson had worked with DeMarco
on the gun-control and tobacco tax efforts. DeMarco "seemed
to have a very successful template for social change
through the political process," Beilenson says. "He's very
good at getting together these coalitions of community
groups, along with working with a smart legislative
proposal and picking the right legislators to carry the
issue."

When DeMarco took on the gun lobby in the late '80s, there
hadn't been any significant gun-control legislation passed
anywhere in the country in years. Yet, three years later,
Maryland signed the Saturday Night Special Ban into law,
and inspired other states to pass similar measures.

"It was at the time the biggest defeat the NRA had suffered
anywhere in the United States for a decade," says Bernie
Horn, A&S '78, a classmate of DeMarco's from Hopkins who
worked on the bill. "Vinny was one of the most famous
opponents of the NRA. Individual NRA members knew and hated
Vinny."

When DeMarco turned his attention to Big Tobacco in the
'90s, C. Fraser Smith declared in a Baltimore Sun
column that the budget surplus at the time meant that a
tobacco tax increase was "simply unthinkable." Yet, two
years later, Glendening signed the increase into law.

Health care would be the toughest fight yet. Though it is
widely accepted that Maryland is facing a health care
crisis, there are huge philosophical differences about what
should be done. Finding an affordable solution would be a
challenge. Once on board with MCHI, DeMarco set to work,
getting funding, researching the issue, rallying
support.

Perhaps the signature element of a DeMarco campaign
is his coalition-building. "I work with a lot of
organizations like Vinny's all over the country and deal
with executive directors who are trying to do as well as
Vinny," says Horn, who is policy director for the Center
for Policy Alternatives in Washington, D.C. "And nobody is
as original, nobody comes up with so many new ways to
organize."

"Vinny is very good at going around and getting the
disparate members of the community, and the groups that are
interested in the issue, all together on the same page, in
the same room, on the same bill," says MCHI lobbyist
Gally.

Early on in a campaign, before DeMarco even thinks about
the Legislature, he and his staff begin holding community
forums — asking questions, addressing concerns, and
getting people to pledge their support.

One of DeMarco's favorite groups to work with is the faith
community. A Quaker, DeMarco is particularly good at
getting religious groups to sign onto a campaign.

"He's very persistent, he's very persuasive, he's kind of
in your face until you begin to take notice of the issue,"
says Bishop Douglas I. Miles, executive director of the
Interdenominational Ministerial Alliance in Baltimore.

The alliance, which has a long history of political and
social action, was a natural fit. But DeMarco also has been
able to bring into the fold faith organizations that
traditionally haven't been political. The Health Care for
All! coalition includes Christian, Muslim, and Jewish
groups, among others. DeMarco, who as a consultant for the
national organization Campaign for Tobacco Free Kids
organized Faith United Against Tobacco, says the faith
community is crucial to a campaign. These groups bring
moral authority, as well as a lot of media attention. And,
he says, "that's where the people are to mobilize."

More than 150 community and religious groups signed on to
support DeMarco's gun-control efforts; the tobacco tax had
more than 350 supporters. MCHI's Health Care for All!
proposal has more than 1,100 state and local organizations
signed on. "As far as we know, it's the largest coalition
in Maryland history," says Beilenson, who chairs its board.

When that kind of coalition kicks into action, politicians
can't help but pay attention. "I get flagged down in the
hallways of Annapolis, and [legislators] say, 'Tell him to
stop getting so many people to call. The phone's ringing
off the hook,'" says Gally. "We hear stories of legislators
getting 400, 500, 600 e-mails and phone calls. . . . These
are real people — these are real people who live in
the districts of the people who they're calling."

"The reality is that when you're successful at doing
this kind of major issue reform, you're going to find your
share of people who resent you for it," says Glenn
Schneider. "And Vinny has his share of people."

DeMarco worked with researchers at the Johns Hopkins
Bloomberg School of Public
Health, the University of Maryland, and Georgetown
University to create the Health Care for All! proposal they
would eventually take to Annapolis. Building on existing
private and public health insurance systems, the plan would
require businesses to offer their employees affordable
health care coverage (those who didn't would be charged a
payroll assessment). The plan would also expand Medicaid
and set up a quasi-public program, MdCares, for those who
aren't otherwise covered. The plan carries a price tag of
about $665 million, which would be funded by a cigarette
tax increase, sliding-scale premiums for moderate-income
adults, penalty taxes on non-participating businesses and
individuals, and by maximizing federal matching funds.

Though Johns Hopkins didn't take a position on the plan as
an institution, the dean of the School of Public Health,
Alfred Sommer, SPH '73, endorsed the Health Care for All!
proposal. And when it came time to announce it, he offered
space at the school for the press conference.

"[DeMarco] captures people who think they're smart by
making them feel like they are the brains behind the
operation. He takes no credit for anything himself; he
props these other people up in front of the camera so they
feel good about it," says Sommer. "And I know this well
because that's exactly what he's done with me."

Of course, not everyone supports the plan, especially the
business community. Robert O. C. "Rocky" Worcester, SPSBE
'72, A&S '73 (MA), president of Maryland Business for
Responsive Government (MBRG), argues that the plan will
actually encourage businesses to drop their health care
plans and pay the more affordable payroll tax instead,
thereby spelling the end of the private health insurance
industry in Maryland. "We want to address the problems
without destroying the system that provides insurance for
88 percent of the population, because 88 percent are
getting the best health coverage in the world," he says.
(According to DeMarco, the plan includes safeguards that
would prevent businesses from discontinuing coverage.)

DeMarco (in plaid) banned smoking from the City Council
offices as "mayor for a day" in high school.

Opponents also argue that the proposal makes businesses
— particularly small businesses — foot the
bill. "The small business community believes, yes, rising
health care costs are a major issue that needs to be
addressed," says Ellen Valentino of the National Federation
of Independent Business. "But establishing a government-run
system funded on the backs of small business is not the
solution."

DeMarco is relentless in the face of such opposition. And
he's pretty insistent when it comes to politicians as well.
Though MCHI doesn't endorse candidates, through the group's
affiliated 501(c)(4) (called Maryland Citizens' Health
Initiative Inc.), DeMarco does encourage all those running
for office to sign a pledge of support. And the coalition
is very aggressive in letting voters know which candidates
support or oppose an issue — holding press
conferences, writing letters to the editor, and dogging
candidates who haven't signed.

DeMarco's opponents say that he can take his methods too
far — that his practice of having legislators pledge
support to a cause, as opposed to a specific bill, is
unfair. "Until you actually see the bill," says Dennis
McCoy, "you really can't say that you'll vote for that bill
even though you may support the concept."

He also has been criticized for going on the attack after a
vote. In 1999, after six Republicans filibustered to stop
the cigarette tax, DeMarco created radio ads that skewered
the candidates for "choosing sides" against kids. The ad
received plenty of criticism — especially for only
targeting the Republican filibusterers and not naming those
Democrats who voted against the bill — and DeMarco
was accused of being a "partisan mouthpiece for the
Democrats."

"The only people on those ads were the people who stood up
and yapped," counters DeMarco, whose voice still carries
traces of his New Jersey childhood. "If Democrats had done
it, they would have been on the ad."

Glenn Schneider, MCHI's executive director, says this just
goes with the territory. "The reality is that when you're
successful at doing this kind of major issue reform, you're
going to find your share of people who resent you for it,
and Vinny has his share of people," says Schneider. "But
more so than that, he's got a legion of people who love him
and his methods and his approach to this kind of work."

Jamie DeMarco, 11, is singing the title song from Man of
La Mancha. We're in Donna's coffee bar in Charles
Village, having just finished breakfast with his dad,
Vinny, and his mom, Molly Mitchell. (Brother Tony, 14, is
away at camp.) As most of the restaurant's patrons quiet
down to listen, Jamie, with his father's encouragement,
offers an enthusiastic rendition:

I am I, Don Quixote,
The Lord of La Mancha,
My destiny calls, and I go!
And the wild winds of fortune
Shall carry me onward, to whither so ever they blow,
Wither so ever they blow,
Onward to glory I go!

"Don Quixote is very symbolic for us. We love Man of La
Mancha," DeMarco says with a grin. Jamie and his
father, who admits to sometimes feeling like he's tilting
at windmills, have listened to the Cervantes book on tape,
watched the movie, and listened to the music.

"It's very inspiring, isn't it Jamie?" says DeMarco.

Mitchell adds, "To see things the way they could be and not
just the way they are?"

This may be the heart of what drives DeMarco. Born in Italy
in 1957, DeMarco came to the United States with his family
when he was 4 years old. They settled in New Jersey, where
they ran a dry cleaning business, and DeMarco became a U.S.
citizen at age 11. One of four siblings, he has a very
close, supportive family. (His mother and sister were
present the first time he argued a case in court, and, to
the judge's surprise, gave DeMarco a standing ovation. His
father still cuts his hair.)

As a kid, DeMarco loved reading about history and politics;
he especially liked biographies of people like Abraham
Lincoln, Martin Luther King, JFK, Eleanor Roosevelt. "From
when I was very young, people who would take on hard
battles to make society better always fascinated me."

As a teenager, he worked on political campaigns and, as
"mayor for a day" during his senior year in high school,
banned smoking from the Hazlet City Council offices.

When DeMarco came to Hopkins in 1974 to study political science, he became active
in the Young Democrats, joined the debate team, and helped
urban kids with reading and math as part of the
Tutorial
Project.

He was also "breathtakingly smart," says Horn. "Classes at
Hopkins were a breeze for him, and all of his friends just
wanted to strangle him because it was so easy for him
— or seemed to be so easy for him — to excel at
Hopkins when we were struggling to figure out what the
professors were talking about."

One of the classes they took together was Contemporary
Political Theory with Richard Flathman. "Of a class of
about 30, about 29 of us didn't know what was going on,"
says Horn. "Professor Flathman and Vinny held a dialogue
for the length of the class, then we would come back the
next week and they'd hold another dialogue."

Jen Hobbins, Glenn Schneider, and DeMarco do their part
to "Bridge the Gap."Photo by Stephan
Lieske

After his junior year, DeMarco left for Columbia Law School
as part of Hopkins' Advanced Interdisciplinary Legal
Education Program. He earned his JD (though barely —
working on Ted Kennedy's presidential campaign instead of
studying, he squeaked by his exams). Then he returned to
Hopkins for a graduate degree in
American history, turning down a very lucrative offer
from a major Washington, D.C., law firm to do so.

After getting his master's degree, DeMarco went to work in
the Maryland Attorney General's Office and eventually
became an assistant attorney general working on licensing
regulation. When the AG, Stephen H. Sachs, ran for
governor, DeMarco quit his job to help with the campaign.
That's when he came across the name Molly Mitchell on a
volunteer card. When he called her about attending a
campaign event, he recalls, "I just loved her voice.
Strange but true. A great, great voice." After the event,
says DeMarco, "I spent the next hour asking about 10 people
there, including Molly, to have pizza afterwards and hoping
the other nine would say no." They did.

DeMarco and Mitchell were married in 1987, when he was 30.
Tony was born in 1990, and Jamie was born on Election Day
1992.

"I think that he's most proud of his title as a father and
a husband," says Schneider. "I've never seen him miss his
sons' baseball games or recitals."

Tony wants to be a major league baseball player. Jamie, who
is more artistic, would like to be an actor. Both seem to
have picked up some of their father's zeal for causes.
Jamie, who hates Wal-Mart because, he says, it uses child
labor overseas and doesn't make health care coverage
affordable for its employees, once asked a delegate
visiting his school whether her bill could be filibustered.
And during a Cub Scout tour of Annapolis, Tony grilled
their guide, another delegate, about where he stood on the
tobacco issue.

As DeMarco has carried on his work — as an assistant
attorney general, as a lobbyist, as the head of one
non-profit or another — it is his family that has
sustained him, he says. They've inspired him as well. Says
DeMarco, "I always think about the kind of world Tony and
Jamie will grow up in."

Delegate James Hubbard and DeMarco before the
march.Photo by Stephan
Lieske

Bad bills take 90 days; good bills take two or three
years," says Delegate James W. Hubbard, who, along with
Senator Nathaniel J. McFadden, sponsored the failed Health
Care for All! bill. "Grassroots always wins, it just takes
longer."

It's a glorious Saturday morning in June, and Hubbard
— along with DeMarco, Beilenson, Schneider, and about
300 other people — has come to Baltimore's Hanover
Street bridge for a grassroots event called "Bridging the
Gap to Health Care." Across the country, according to the
Service Employees International Union (SEIU), which
organized the event, tens of thousands of people are
crossing bridges in similar walks meant to call attention
to the 44 million Americans without access to health care.
The crowd in Baltimore isn't huge, but it's in high
spirits.

"A powerful grassroots coalition can make a difference,"
says DeMarco. "What happened this session, the fact that
this health care expansion came so close after being
nowhere for so many years, is a testament to the power of
this coalition."

Now that coalition is making plans for the 2005 legislative
session. They are holding so-called "listening meetings" to
decide whether to introduce the Health Care for All! bill.
They are working with Maryland senior groups to highlight
problems with the recently enacted Medicare Prescription
Drug law, encouraging the Maryland General Assembly to pass
legislation that would allow the state to negotiate cheaper
drug prices with pharmaceutical companies. They are working
with hospitals around the state to make sure that patients
know about the financial assistance policies that are
already in place. And they hope to launch a campaign this
fall that would educate doctors and other health care
providers about what commonly prescribed drugs actually
cost.

All these steps are in the right direction, says DeMarco,
but they're not the end. "We've got to keep the goal of
health care for all. That's got to happen."

Is he aiming too high this time? The people who have
watched him and worked with him through the years don't
think so.

"That's the fight he thinks needs to be fought," says Horn.
"If he's not going to take on the biggest obstacles to
progress, who will?"